Article Summaries
Dichgans M et al. Angiographic complications in CADASIL. Lancet. 1997;349:776-777. Abstract
The authors identified 16 CADASIL patients who had undergone cerebral
angiography. In 11 of the patients cerebral angiography induced neurological
complications, which were transient in six, reversible in three, and
permanent in two patients. Symptoms included dysphasia, visual impairment/cortical
blindness, confusion, motor and sensory deficits, epileptic seizures,
headache, vomiting, and vertigo. In two patients, angiography led to
cerebral infarction. The findings indicate that CADASIL patients are
at higher risk for angiographic complications (69%) than expected (0·5–5·6%).
The authors speculate that structural vessel abnormalities in CADASIL
may make patients vulnerable to a toxic effect caused by contrast agents
and conclude that cerebral angiography is contraindicated in CADASIL
patients.